'Ventriloscope' Is New Approach to Med Training

A modified stethoscope for trainees that reproduces real patient sounds when used on healthy actors is now available from an Ohio-based company.

by Deanna Pogorelc MedCity News

The stethoscope is of the most fundamental tools for doctors and can be one of the most powerful in initial detection of cardiac or pulmonary illnesses. That's why Paul Lecat, MD, wanted to give medical educators a better way to teach students to use it and understand what they hear at a basic level.

For the past 5 years, Lecat and his wife, Fran, have bootstrapped a company called SimplySim. Lecat is a primary care physician who works with medical students as the chair of medical education at Akron General Medical Center and an adjunct professor at Northeast Ohio Medical University in Rootstown, Ohio.

"One of the frustrations is that they do a beautiful job of simulating encounters by having students interview actors and work on their communication skills," he said. "The problem is, when they go to examine patients, they don't have any real physical findings."

The device that SimplySim produces is called Lecat's Ventriloscope. It looks like a stethoscope but has a receiver box between the headpiece and the chestpiece. That receiver is connected wirelessly to a remote control used by an actor who's portraying a patient during a mock examination.

The sounds that the student hears through his stethoscope during the exam are controlled by the actor or the instructor. They're sounds that have been digitally recorded from real patients (with their approval, of course), to simulate what a doctor would hear when examining a patient with a heart murmur or atrial fibrillation or tachycardia, or a number of other conditions.

Intended to be used alongside a mock patient history and physical exam, the Ventriloscope is designed to help students recognize abnormalities that might give them clues to what's really going on with a patient.

"The physical exam is key in choosing which tests are ordered further down the line," Lecat said. "One problem in medicine is we tend to just order a list of tests without thinking. We're trying to get them to be a little more thoughtful."

With the Ventriloscope, standardized patients can stop and start the sounds when they feel the stethoscope touch them, or can alter the sound if the stethoscope isn't placed in the right spot. For example, wheezing encroaches more on exhalation, Lecat said, so if the student pulls away the stethoscope too soon, the standardized patient can stop the sound.

Many teaching hospitals use simulation mannequins for this kind of practice, but aside from the tens of thousands of dollars they cost, they tend to be complex machines that require setup by a trained personnel.

They also can't respond to the exam the way actors can, Lecat said. And, the digitization of the stethoscope makes it easy to time stamp every action so that instructors can document the student's actions and confidently evaluate or test them.

The Ventriloscope runs about $8,000 and is already in use in 200 schools across 10 countries for training of paramedics, nursing students, medical resident and even practicing physicians, Lecat said.

Now the company is looking to expand its product offering. Existing clients have requested custom sounds, and one idea is to put together packages of sounds for certain specialties, like pediatrics or nursing.

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